Bed registry means coordinated care for those in a mental health crisis

806

A 49-year old woman, fed up with waiting for admission to a psychiatric bed, walked away from an Ontario hospital to her death. She had spent three days on a stretcher in an emergency room cubicle as staff searched in vain for an appropriate bed. Her body was found behind a lumber yard, a day after she went missing from the hospital. She had committed suicide.An inquest revealed that her story was not an isolated case. In fact, every year in Ontario many people take their lives while waiting for the mental health help they need.

Within the region of Simcoe and Muskoka, mental health beds are distributed across three sites and distances between sites are significant. Access to care in a timely fashion has been an issue, until now. Royal Victoria Hospital’s (RVH) Peter Stanczyk is leading a project which will help assure quick access to those much-needed mental health beds for people in crisis and in need of hospitalization or community-based mental health and addiction help. “Our vision was initially to create a single, client-centered and coordinated network of care for the delivery of hospital-based acute care mental health services in Simcoe County and the District of Muskoka,” says Stanczyk. “That was our original vision but it has expanded considerably, to now include a wide range of community partners across the care continuum.”

From that vision the Simcoe Muskoka Regional Acute Mental Health and Addiction Service was created and Stanczyk is currently the Operations Director. This innovative system of delivering care to mental health clients in the region is overseen by one clinical and one administrative regional leader. It is a collaborative service involving all the hospitals in LHIN 12, as well as many community partners which deal with mental health issues and/or addiction services such as the Canadian Mental Health Association which operates community crisis beds, and residential withdrawal management services sponsored by RVH.

The jewel of the project is the central bed registry which identifies all available adult psychiatric beds within the LHIN on an hour-to-hour and day-to-day basis. The central bed registry, the first of its kind in the province, for adults requiring an inpatient admission for mental health reasons, allows emergency departments and community crisis workers quick access to a computerized registry of all available beds in the region, both hospital-based and community-based, in real time. With the click of a computer mouse staff are able to see where the closest available bed is and have the patient in crisis transferred there as soon as possible.

“I’m very excited to see the mental health and addiction services of this region work together to streamline the process of accessing beds. I’m not aware of any other region in the province that has an adult mental health bed registry. This is a first,” says Stanczyk. “The registry is a central coordinating tool, critical to the functioning of a comprehensive array of services which make up the care continuum for those seeking help for a mental health or addiction issue.”

The chief architect of the bed registry, Norm Petroff of the IT Department of the Mental Health Centre Penetanguishene, developed the acute mental health bed registry after extensive consultation with the steering committee designing the regional service. “Now that we’ve gone live, there has been active interest in the adult acute bed registry from other parts of the province,” Petroff says. “The registry has direct links to both our LHIN website and the site of the Regional Acute Mental Health and Addiction Service for Simcoe and Muskoka. As well, the registry has been designed such that other hospitals within other LHINs could easily be added, making this a very marketable tool.”

The project’s aim is to not only provide timely access to mental health beds but also consistent care for patients whether they are admitted to Royal Victoria Hospital in Barrie, Soldiers Memorial Hospital in Orillia, the Mental Health Centre Penetanguishine or to the community-based crisis and withdrawal management beds.

It is estimated that one in five people in Canada will, at some point in their life, be coping with some form of mental illness. The effects of mental illness can be far reaching and will impact upon ones’ family, relationships and employment. “The stigma often associated with mental illness is especially difficult to erase and prevents many in need of help from seeking it. Mental illness knows no boundaries. It can affect all people regardless of age, culture, income or education,” explains Petroff.

Of the ten leading causes of disability worldwide, five are mental health disorders – depression, schizophrenia, bipolar disorder, alcohol use disorder and obsessive compulsive disorder. Every year RVH, one of the three hospitals with beds noted in the bed registry, admits more than 900 people suffering from a mental health disorder, with an average length of stay of about ten days. “We want to ensure that all the mental health clients in our region have quick and equal access to an acute bed and consistent care wherever they are when they find themselves in crisis,” says Stanczyk